Integrative medicine is something that many adults have incorporated into their lives—you may have tried acupuncture, massage therapy, or received chiropractic care.
But you may be surprised to learn that integrative medicine can help children too. Pediatric integrative medicine is different from what a standard paediatrician might provide, says David W. Miller, MD, LAc, medical director for paediatric integrative medicine at UH Connor Integrative Health Network.
“Pediatric integrative medicine is a philosophy of care and a way to incorporate evidence-based modalities to look at the child as a whole,” says Dr Miller, an integrative medicine physician who specialises in paediatrics. Before specialising in this field, Dr Miller was a hospital physician and general paediatrician.
“We look at children in the context of their family, in the context of their community, in the context of their emotional state, what their diet is like, what their sleep is like, what their exercise is like,” says Dr Miller. “We’re trying to bring all of that together into a picture that best describes their current health status and look for places where we can improve.”
In an ideal world, every child would have access to such an evaluation and perspective, says Dr Miller, though he’s the first to say the mainstream medical system is doing a great job with speciality care, health screenings, critical care, and providing the foundation for preventive medicine.
But, he notes, the kind of work that paediatric integrative medicine entails just takes more time.
“It’s a joy to do when you enjoy doing it, which I do,” he says. I will be at an intake for an hour to an hour and a half, often with a family. Thereafter, depending on the complexity of the case, follow-up visits may be made. It’s easy to recommend a family to try dietary changes; it’s more challenging to help them actually achieve those new eating patterns and track their outcomes to make sure those changes are making a meaningful difference in their health status.
“It’s easy to surmise that family dynamics, trauma, stress, or other issues strongly influence the medical presentation, but it’s much more complex to dive into that and determine how to navigate their plan of care. Seeing how all areas of life connect a patient with each other and influence their health status is at the heart of the integrative approach. Incorporating not-commonly available tools, such as acupuncture, mindfulness, or bodywork to enhance that symphony of interactions is also part of the challenge.
“We work through many different aspects of health and wellness in a way that, for example, I didn’t have time for when I was working as a general paediatrician.”
He gives examples of children with certain health problems that he has treated.
“A 9-year-old boy was diagnosed with ADHD, and there were some concerns about behaviour problems and maybe developmental issues,” he says. “So I met the family and talked to the child, got to know them, and there were areas for intervention that came up.”
In that case, the child’s diet was one of them. “He had problems with certain foods, such as refined sugars and foods with chemicals on the ingredient list,” he says. “And after the child consumes that food, his mood and behaviour become unbalanced.” It wasn’t the full cause of his problems, but it was a big piece of the puzzle.
Dr Miller helped the family see that connection. Over time, the aim is also to build an understanding of the child himself so that he can learn how his body responds to those foods and make informed choices about food throughout his life. Dr
. Miller also completed four years of training in Chinese medicine, including Chinese herbal medicine.
In the case of this 9-year-old boy, we also included some herbal formulas that had a wonderful effect. It was really dramatic, actually, “he says.”
Parents also play a role, such as in the practice of integrative medicine for children.
“We provided tools on how to manage meals and encourage different types of exercise for the child,” he says. Things like martial arts can sometimes be a great training tool for kids, both for the practice component and also for the self-discipline, coordination, and mind-body connection.
A complementary approach
Other conditions for which Dr Miller often sees patients include gastrointestinal disorders such as constipation or diarrhoea. “Abdominal pain is a category of condition that we see great results from,” he says. Asthma can be another, as can chronic ear infections, chronic pain conditions, and emotional and behavioural imbalances. Many of these are rooted in problems with diet and sleep. “
Trauma can also be helped by taking a mind/body approach because it affects both children and adults both physically and mentally.
“Valuing that interconnectedness and working top-down and bottom-up to regulate after a traumatic event, I think, can be exponentially more effective than going in one direction.”
Dr Miller says that integrated paediatrics does not replace the care provided by your primary physician, especially in university hospitals, but is complementary. A child should still be connected to a paediatrician for primary care, such as for annual physical exams.
It is also worth noting that parents seeking paediatric integrative care should consider the provider’s credentials. Some call themselves integrative caregivers, and yet they can come from any type of medical or even non-medical background. Check the provider’s credentials to see how he or she is certified in integrative medicine, as well as whether and how they are connected to a health care system where traditional care, including surgery or emergency care, can be provided when needed. There are many local companies that sponsored children’s clinics.